319株ICU病原菌分布特点及抗菌药物敏感率分析  

Analysis on 319 strains pathogenic bacteria distribution and antimicrobial drug sensitive rate in ICU

作　　者：王秀云[1] 周秋峰[1] 崔向丽[2] 

机构地区：[1]北京市房山区第一医院药剂科,102400 [2]首都医科大学附属北京朝阳医院药事部

出　　处：《中国急救复苏与灾害医学杂志》2014年第2期132-134,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的：探讨ICU病区病原菌分布特点及药物敏感率情况，为临床合理选用抗菌药物提供参考。方法统计2012年7月~12月北京天坛医院ICU检出病原菌的种类、数量、标本来源及药敏结果等数据，并分析这一时段ICU病原菌的流行特点及药敏和耐药特点。结果ICU分离的病原菌来源主要是痰标本，占79.0%。病原菌种类革兰氏阴性菌占76.2%，革兰氏阳性菌占23.8%。常见革兰氏阴性菌前3位依次是铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌。其中鲍曼不动杆菌耐药严重，对美罗培南的敏感率只有9.8%。革兰氏阳性菌中以金黄色葡萄球菌为主，占81.6%。金黄色葡萄球菌中耐甲氧西林的金黄色葡萄球菌（MRSA）占61.3%；凝固酶阴性葡萄球菌中耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）占45.5%。结论由于ICU抗菌药物使用频率高、剂量大、时间长等原因，导致病原菌敏感率低，耐药严重。医院应加强ICU抗菌药物使用的监督和管理，避免耐药率上升。Objective To discuss explore characteristics of pathogenic bacteria distribution and antimicrobial drug sensitive rate in ICU, and provide the reference for clinical antimicrobial drug usage. Methods Data on pathogenic bacteria species, number, antibiotic susceptibility results and others collected at ICU of Beijing Tiantan Hospital in between July and December, 2012 was analyzed. Results Sources of pathogenic bacteria at the ICU were mainly separated from sputum, accounting for 79.0%. Species of pathogenic bacteria were mainly G- bacteria, accounting for 76.2%and G＋bacteria account for 23.8%. The top three types of G- bacteria were pseudomonas aeruginosa, klebsiella pneumonia and acinetobacter baumannii. Drug resistance of acinetobacter baumannii reflected being serious, and the sensitive rate to meropenem was only 9.8%. The most popular G＋ bacterium was mainly staphylococcus aureus, accounting for 81.6%. Among Staphylococcus aureus, methicillin-resistant staphylococcus aureus （MRSA） account for 61.3% ; among Coagulase negative staphylococcus, methicillin-resistant coagulase negative staphylococcus （MRCNS） account for 45.5%. Conclusion Due to the feature of high frequency, high dosage, and longer time of antimicrobial drug usage in ICU, it lowers the frequency of sensitivity and increases antibiotic resistance. The use of antimicrobial drugs in ICU has to be more cautious in order to avoid unnecessary drug resistance.

关 键 词：ICU(重症监护病房) 病原菌 敏感率 耐药率 

分 类 号：R969.3[医药卫生—药理学]